
<!DOCTYPE html>
<html lang="en">

    <head>

        <meta charset="utf-8">
        <title>SopraCov</title>
        <meta name="viewport" content="width=device-width, initial-scale=1.0">
        <meta name="description" content="">
        <meta name="author" content="">

        <!-- CSS -->
        <link rel='stylesheet' href='http://fonts.googleapis.com/css?family=PT+Sans:400,700'>
        <link rel='stylesheet' href='http://fonts.googleapis.com/css?family=Oleo+Script:400,700'>
        <link rel="stylesheet" href="assets/bootstrap/css/bootstrap.min.css">
        <link rel="stylesheet" href="assets/css/style.css">
		<link rel="stylesheet" href="assets/css/test.css">

        <!-- HTML5 shim, for IE6-8 support of HTML5 elements -->
        <!--[if lt IE 9]>
            <script src="http://html5shim.googlecode.com/svn/trunk/html5.js"></script>
        <![endif]-->

    </head>

    <body>
        <img id="image" src="./images/Sopragroup.png" alt="" />
        <!--BEGIN #signup-form -->

        <div class="register-container container">
            <div class="row">
                <div class="iphone span5">
                    <img src="assets/img/iphone.png" alt="">
                </div>
                <div class="register span6">
                <p>S'il vous plaît, remplissez les champs ci-dessous en vous assurant de fournir une adresse mail valide 
	        </p>
                <form method="POST" action="FormServlet">
            <label><h4>Nom *</h4> </label>
            <input type="text" name="Nom" id="required"><br/>
            <label><h4>Prénom *</h4> </label>
            <input type="text" name="Prenom" id="required"><br/>
            <label><h4>Mot de Passe *</h4> </label>
            <input type="password" name="Passe" id="required"><br/>
            <label><h4>Email *</h4> </label>
            <input type="email" name="Email" ><br/>
            <label><h4>Telephone *</h4></label>
            <input type="text" name="Tel"><br/>
            <label><h4>Commune *</h4></label>
            <input type="text" name="Commune" id="required"><br/>
            <label><h4>Code Postal *</h4></label>
            <input type="text" name="CodePostal" id="required"><br/>
            <label><h4>Lieu de travail *</h4></label>
            <SELECT name="Workplace" id="required">
                <OPTION VALUE="BLAGNAC">Blagnac</OPTION>
                <OPTION VALUE="COLOMIERS">Colomiers</OPTION>
            </SELECT>
            <br/>
            <label><h4>Heure départ matin *    ex: 11:32</h4></label>
				<input type="time" name="HDMatin" id="required"><br/>
            <label><h4>Heure départ soir *    ex: 11:32 </h4></label>
				<input type="time" name="HDSoir"><br/>			
            <label><h4>Jours applicables</h4></label>
			
							
			<div class="check">
				<label id="checkbox">Lun</label><input type="checkbox" name="Lundi">
				<label id="checkbox">Mar</label><input type="checkbox" name="Mardi">
				<label id="checkbox">Mer</label><input type="checkbox" name="Mercredi">
				<label id="checkbox">Jeu</label><input type="checkbox" name="Jeudi">
				<label id="checkbox">Ven</label><input type="checkbox" name="Vendredi">
				<label id="checkbox">Sam</label><input type="checkbox" name="Samedi">
				<label id="checkbox">Dim</label><input type="checkbox" name="Dimanche">      
            			
				<label id="checkbox"><h4>Conducteur </h4></label><input type="checkbox" name="Conducteur">
				<label id="checkbox"><h4>Souhaite être notifié:</h4></label><input type="checkbox" name="Notif">
			</div>
            <a href="connexion.jsp">Annuler</a><span class="fontawesome-arrow-right"></span><th/><th/><th/>  			
            <button id="submit" type="submit">Submit</button>
        </form>
		
                
        <div id="required">
	<p>* Champs requis<br/>
	</p>
	</div>
        
                </div>
            </div>
        </div>

        <!-- Javascript -->
        <script src="assets/js/jquery-1.8.2.min.js"></script>
        <script src="assets/bootstrap/js/bootstrap.min.js"></script>
        <script src="assets/js/jquery.backstretch.min.js"></script>
        <script src="assets/js/scripts.js"></script>

    </body>

</html>

